Industry professionals gathered virtually to engage in the ICAA’s 2021 Forum focused on Wellness attracting the Middle Market. While building upon concepts that emerged from the 2020 Forum, attendees were charged to identify consumer persona attributes, discuss the benefits of leveraging the various dimensions of wellness and to strategize on opportunities for meeting the needs and aspirations of prospective residents, family, and staff. During the Plenary session, we were honored to share details surrounding our Wellpoint Community project alongside co-panelists Michael Tompkins of Hutchinson Consulting and Chip Conley of Modern Elder Academy (“MEA”).
Historically, the senior living sector has been slow to adopt new ideas or enabling technology. The wheels of change started to turn more quickly over the past decade due to increased focus on entitlement insolvency, awareness of Age Wave demographics and the regulatory paradigm shift toward value-based care where providers recognized a passive mandate to either Lead or Exit. While there are always outliers returning from the wilderness with bold ideas, meaningful collective progress in the Senior Living Industry has largely been moving at a snail’s pace.
Over the course of two days, it quickly became evident that there is a common journey underway where we all (professionals and consumers alike) are seeking greater meaning and choice from the communities that we design and/or choose to call home. While there is no question that the current emphasis on Wellness Real Estate favors a more affluent market, it seems evident that the systems approach that a true wellness offering demands will naturally preserve and/or reveal opportunities for all age cohorts and income classifications to come together and care for the larger self.
Insights from the Panel
Joseph McCarron – CEO of Wellpoint Community – described the kit-of-parts representing our prototype and business plan. A cornerstone of this strategy is to deliver an expansive menu of personalized program options. The confluence of senior living, integrative medicine, boutique hospitality and residential living on a single site promotes the convenience of access, choice and affordability. These attributes garner intergenerational appeal and create opportunity for the emergence of a genuine community.
Michael Tompkins’ career history and experience qualifications ideally exemplify the exhibiting convergence of healthcare and hospitality – two umbrella keywords that largely treetop the diversity of sectors representing the Global Wellness Economy. Having seeded his career in nursing care, his direct caregiving foundation and executive achievements position him to have a leading influence in combining and aligning these sectors while honoring the valued perspective of guests and staff alike.
Chip Conley has been playing a leadership role on the world stage for decades and the Senior Living Industry is fortunate to have gained his captive interest and ambition. As a repeat industry disrupter, he laid the groundwork for his current focus with the lessons he shared in “Wisdom at Work: The Making of a Modern Elder.” While ageism in the modern workplace can largely be addressed by honoring the experiential knowledge (wisdom) of elders, the broader detriments of modern culture do not appear to have any modern antidote. As he transitions toward helping to redefine retirement, his emphasis on championing “regeneration” with a biodynamic approach to “Regenerative Community” holds another possible lesson that we wish to amplify after offering some context.
What is Regenerative Agriculture?
Any phrase that is prefixed with “regenerative” can be contextualized by understanding the history of the regenerative agriculture movement. Charles Massey’s 2018 TEDxCanberra Talk provides a token example of the growing sentiment that reconnecting to nature and its wisdom is a prerequisite to healing ourselves. Simply stated, Modern Agriculture and Modern Medicine (Sick Care) are the culprits behind our dis-ease states. Are we sick largely because of the way we eat and the way we farm? What if reclaiming our knowledge and wisdom about nature could also help to reconnect us with our own health and well-being? While we have not yet had the opportunity to confirm the sentiment, it seems clear that Chip and other pioneering minds understand this to be true.
Everything in its Time
When the Global Wellness Institute (GWI) released their “Build Well to Live Well” report in January 2018, they helped to fortify an idea that had been germinating for decades without requisite support or nourishment outside of senior living. Creation and evidence-based promotion of the “Wellness Real Estate” and “Wellness Community” banners empowered them to leap frog competing green building interests and galvanize professional and public support towards recognition that our built-environment is likely the greatest determinant of our health and well-being. More specifically, GWI asserted that up to 80-90% of health outcomes depend upon the external and environmental factors in our “wellness ecosystem.” If you layer on to this groundswell of commercial real estate interest in wellness that “nursing homes” emerged as a crisis center during the COVID-19 pandemic, it is no wonder that so many Industry Stakeholders are finally focused on creating healthier spaces and places.
In a time where “wellness washing” is running rampant, we are all being called to under-stand and share the “what” and “why” of our approach so that others can feel the pull and participate in both the programs and their overarching purpose – to pursue higher levels of meaning, engagement, support, and activity together.
Everything in its Place
In their 2012 research article “Designing from Place: A regenerative framework and methodology,” Pamela Mange and Bill Reed offer that “Transitions to new worldviews ‘take hold’ as the new paradigms they give rise to become embedded across disciplines and fields of endeavor, increasingly being manifested as accepted standards, protocols and processes.” In this paper they are referring specifically to the paradigm of regenerative thinking and outline four criteria or gateways through which we must pass in order to complete this shift of thinking and being.
People must take their place again in nature and focus creative and economic activities toward the development of human potential.
A mental shift is required where we bring a “new mind” to the generative thinking that has shaped our buildings historically. In keeping with the natural order of the web-of-life memetic, we should conceive of our site, infrastructure, and inhabitants as dynamic and interconnected flows of energy.
We must cultivate enough eco-literacy to support such attempts at biomimicry.
Work developmentally toward constantly seeking the next level or relative hierarchy.
In a final nod of tribute to the relevancy of this important article, Charles Krone’s Levels of Work Framework is shared to graphically reinforce the sentiment that evolutionary processes (potential) will never be engaged if you are only operating within the explicate order of maintenance and operations.
Whether we are referring to our culture, our industries, our business or even our own cellular structure, we are reminded of the requisite balance between chaos and order that defines all complex adaptive systems (nature). If we want to attract any market to our “Wellness” offerings we should first focus on an organic approach where we lead with authenticity and diversity of choice/offerings.
Takeaways
The Forum proved an engaging event that bred genuine enthusiasm and creative thinking surrounding the change scape represented by the Senior Living Industry.
Lifestyle offerings that promote enriching lives and active engagement will augment if not supplant the traditional provider focus on ageism and supportive care alone.
New business models responsive to consumer choice will continue to prove threatening to the traditional senior living communities.
Flexibility and choice of offerings will foster growing collaboration and convergence of all stakeholders in aging services.
Emerging from the devastating consequences of the COVID-19 circumstances is a heightened awareness and demand for “living well” at home with catered service offerings. At the same time, opportunities for meaningful social connection (digital and In-Real-Life) are critically important. The Senior Living Industry is ripe for leading a strategic societal redirection given these exhibiting trends and the profoundly changing consumer profile.
A consumer centric strategy will require more education, integrative thinking, and execution that pioneers a balance between self-care, social wellness and eco-literacy.
Consumer needs, preferences and expectations mandate a dramatic new approach to real estate development and operational programming that is highly personal, modular, adaptive and cued by progress toward the new “future of medicine.”
We advocate “Redirecting” and “Cultivating Convergence” for the future of aging services – “Where It All Comes Together”. Undoubtedly, dramatic change abounds. If adversity truly breeds opportunity, change agents alert to new directions stemming from “systemic” and “holistic” strategies more aligned with the “natural order of things” are poised for great success.
On October 25, 2019 The Age Friendly Foundation launched its inaugural Revolutionize 2019 Conference Event held at the Seaport Hotel in Boston, Massachusetts.
The event was co-sponsored by the Boston Chapter of Aging 2.0 and
included over 300 attendees representing a diverse forum
of business and industry stakeholders engaged in aging services. The Foundation was established in late 2018
as a vehicle to augment the continued growth of the Aging2.0 Boston Chapter’s
programming together with related advocacy, education and events that champion
healthy, active and productive aging for all ages.
Recently named the Silicon Valley of Aging by
Inc. Magazine, Massachusetts provides an ideal backdrop to this international
conference event promoting innovations in aging. As a center of pioneering research,
education, healthcare, technologies and public policy, Boston is the perfect
host to Revolutionizing the “Future of Aging”. Revolutionize 2019 represented a
diverse assembly of “Best-in-Class” thought leaders coming together with
integrative intentions.
SHARING MOONSHOTS
When the “Revolutionize” theme for this Fall’s
conference was seeded, we reflected on the humbling reality that early American
colonists were relying upon hand-written letters or printed pamphlets that had
to be carried by horseback or ship in order to share knowledge with cities and
the rural lands where so many lived. The Committees
of Correspondence that were ultimately formed and networked could arguably
be credited for our ultimate success in organizing for Independence. Fast forward to today, where technology
empowers us to connect instantly across the globe and it follows that we should
be able to advance any common cause with ease IF we pursue it together. Successful
outcomes naturally hinge on our ability and willingness to adopt shared language
(or data) and ensure its “interoperability” for all stakeholders.
Simply stated, the common cause for this
inaugural year of Revolutionize is to transform our views and practices surrounding
so-called “aging services” in an even more inclusive and progressive
fashion. The consumer profile underlying
“senior living,” and or “age-tech” designations are profoundly changing – induced
by unprecedented longevity and clearly emerging preferences for wellness, lifelong
learning and active engagement that unifies rather than divides. Conveniently,
this shift amplifies the needs and desires of all age groups and all 8,000
day life stages in our emergent Four
Generation Society.
Key attributes of this new landscape will exhibit
growing intergenerational presence, new technologies, progressive programming
and escalating capital resources to support healthier, active and enriched
lifestyles for everyone.
SOCIAL INCLUSION
In his opening keynote, Dr. Alexandre Kalache set the stage for a new chapter in the Age Friendly Movement by amplifying the theme of growing inequality (economic, racial, gender, age-related) across both the United States and world stage at large. His remarks inspired us to acknowledge that we can likely accomplish even loftier goals if we focus on macro issues like social inclusion but approach them from a micro (local) perspective. This insight (arguably inspired by his formative role in the Age-Friendly Cities program) amplifies recognition that a bottom-up process is most effective when you are trying to turn the wheels of change.
The WHO Global
Network for Age-friendly Cities and Communities currently includes 1000
cities and communities in 41 countries, covering over 240 million people
worldwide. On April 12, 2017, Governor Baker signed Executive Order 576
establishing the Governor’s Council to Address Aging in Massachusetts and the
Commonwealth became the 2nd state in the nation to enroll in the AARP Network
of Age-Friendly Communities. During his 2019
annual State of the City address Mayor Walsh announced the launch of the Age
Strong Commission (previously known as the Commission on Affairs of the
Elderly). More recently, he has launched the AgeStrong Public Awareness
Campaign to further support awareness of inclusion and the fall conclusions of an
ageist perspective:
While the general eight-domain
framework (branded by AARP as Livability)
dovetails with many other overlapping standards, it is the policy connection,
action plans and subsequent traction in the City of Boston, State of
Massachusetts and across the country and globe that makes this movement
noteworthy and deserving of active acknowledgment, promotion and advancement.
DON’T TREAD ON ME
When Dr. Joseph Coughlin took to the stage to
close the event, he challenged the audience to take up arms (metaphorically) at
a deeper level. If we want to
“revolutionize,” it follows that we ought to be truly revolutionary in our speech
and in our thinking. He proffered further that specific words, like
Age-friendly, Livable, Caregiver & Mobility ought to be abandoned as we
charge ahead. While words do matter, we
advocate that recognition should be given to those that have already taken root
in our communities and represent progressive movements to be expanded upon. Age Friendly primary among them.
In reflecting further upon the attributes of a
true “revolution,” Coughlin cited that signs and symbols are typically at the
epicenter of all social movements. The best symbols are often simultaneously
generic and descript in their messaging so that a majority can rally to its
messaging in a more personalized way that still honors the collective intent. The
revolutionary symbol of “Don’t Tread On Me” comes to mind where the pictorial
snake mantra of “Join or Die” for the 13 colonies is juxtaposed with the more
deeply rooted anthropomorphism of a Rattlesnake and its deadly bite when
threatened. In a modern era where corporate or personal branding has taken
precedence over the tribal markings, tartans or nation flags of old, what is
the next banner we might wave intentionally as a collective humanity?
FORWARD MARCH…
Revolutionize denotes initiatives to effect a
radical change to existing conditions.
The dramatic change landscape exhibited by aging services and all its
influencers is replete with opportunities yet burdened by challenges. We can be the change agents analogous to our
revolutionary forebearers – marshalling everyone together in a common cause –
to deliver upon recognizing that aging is a national treasure rather than a
burden to carry. Fueled by knowledge,
experience and tools of advancing technologies, we can indeed foster the
requisite collaboration for a forward march and be the catalysts for
convergence to reimagine and redirect the future of aging – for all ages!
The UMBC Erickson School’s 7th Annual Memory Care Summit in Orlando delivered on i`ts promise “to transform thinking about memory care.” This year’s program theme of “connections,” was inspired by Dr. Judah Ronch’s presentation surrounding brain science and neural network mapping. His message was clear. Each of us are entirely unique by virtue of both the memory formation and retrieval processes. In fact, even a singular memory becomes layered with individuality as it is compounded by recollection. We left the conference focused less on the hard science of 3D brain scan imagery and more on the natural rhythms of engagement – and how active awareness and recognition of this process can lead to higher states of order. Whether we are talking about people, projects or memes themselves – multiple associations will always create resiliency. This continuously programmable framework helps to either sustain or redefine our elusive and ever-changing concepts of “self” and “other.”
Connectomics
While recapping the conference in prior years, we have always emphasized the intentional bookends crafted by The Erickson School. Dr. Ronch launched the first day by reflecting upon the concept of the “connectome” and how its lessons can help us to improve and expand upon the culture change movement that is still underway. In essence, person-centered or person-directed care is not just a good idea – it is an elevated approach that honors the power and persuasiveness of partnership.
If you are not familiar, the Human Connectome Project represents the scientific moonshot of mapping the neural pathways in the brain of healthy adults. Sebastian Seung’s popular 2010 Ted Talk, “I am my connectome” introduced this concept to a mainstream audience:
Did you know that our connectome is presumed to be as individual as our genome? If you want to learn about the staggering complexity of this mapping project and where we are collectively in the research process, please find time to view the “Cartographers of the Brain” panel from 2017’s World Science Festival:
Our biology is so incredibly (and infinitely) complex, as each of the panelists attest, that any expert worth their salt is humbled by its study. Nothing we have created to date can compete with the technology of nature. In a time where man-made technology is revered, it is important to acknowledge how little we know about everything.
Designing with Intention
The Disney Institute’s Program Facilitator, Mark Matheis conducted a behind the scenes tour of the Magic Kingdom for us after an introductory presentation. When you learn about the Disney Culture, it is always emphasized that they have “learned to be intentional where others are not.” While walking down Main Street, we were educated on how this philosophy manifests in practice. All design elements work together to reinforce a positive experience for guests of all ages and backgrounds.
At the surface level of Main Street, every architectural and operational detail influences our behavior and engagement with the environment. Literally, just beneath the surface, a vast network of infrastructure sustains the quality and nature of that street-level experience. Disney understands what people of all ages hold in common, but they also strive to capture and account for our uniqueness. This is accomplished by combining cultural and psychological influences and establishing something that appears to be uniform but has been aggregated from the broadest spectrum. For example, the building facades borrow something from architectural styles around the world. Wherever you’re from, it is possible for you to feel at home on Main Street.
Yes, And
In a standout session led by Erickson graduate Donna Poole and her daughter Jessie, we were introduced to their personal experience connecting caregivers with the lessons of improvisational theater. If you are already familiar with this coupling, please share it broadly. We would also recommend reading Yes, And, and viewing the 2018 NIC Talk by Kelly Leonard:
There was a palpable change in the audience during this particular session because of how impactful it was. We were all intensely moved by their story and its delivery. The quality of observations from attendees during the Q&A seemed to affirm that we had all literally been uplifted – especially in our collective thinking. When we first started talking about the “connectome”, we were looking at images of the brain alone. Someone suddenly made a loose (almost transcendent) comment about the presence of memory outside of the brain for the first time since the Summit began. As Deepak Chopra consistently relays,
“Instead of conceiving reality from the bottom up, moving from tiny building blocks to larger and larger structures, one could do the reverse and create a top-down model. In other words, the starting point would be the whole, not the parts. So what do we know about reality as a whole?[1]”
It is legitimate to focus on the brain and its immediate connectome, because we must start somewhere. Let’s just not forget that we have mountains to climb! There is a larger question about consciousness and the nature of “mind” that needs to be addressed.
A Call to Mind
We view the founding Erickson mission of combining aging, management and policy as being more timely now than ever before. Recalling that enduring progress does take time, there is finally a clear opportunity emerging from the groundswell of interest and legislative traction related to the Age-Friendly Movement. Whenever keywords surrounding the World Health Organization’s Network, Livability or up and coming building/occupant performance standards like, WELL or Fitwel surface, we are both excited and disheartened. Excitement exists because we believe in the power of shared and comprehensive frameworks to transform culture. We are disheartened because we also recognize the power of babel. There are so many competing standards and movements in our industry alone – let alone in and across other sectors and geographic boundaries. If we really want to “connect,” a unifying banner is imperative.
For the first half of the Summit, the Age-Friendly movement surfaced a few times as a talking-point. After Donna’s session, we started to make open reference to its all-inclusive nature. Just as the mind, memories and our personal identity transcend the physical brain, Age-friendly is not about “Older Americans” alone. It is (at least we hope) about being “mindful” of how to integrate everyone within an intentionally supportive community infrastructure. As the lead for WHO’s network in the United States, we commend AARP for positioning this standard as “livability” – with relevance to all ages. We should not have to visit Disney World to experience the magic of Placemaking or Building Healthy Places!
The State of Emergency
On day two, newly appointed Secretary of Elder Affairs, Richard Prudom, enlightened us about the scope of planning and coordination undertaken by the State of Florida for disaster planning. Together with Kathryn Hyer, Ph.D., representing the Florida Exchange Center on Aging, we witnessed a compelling case study surrounding the state and local collaboration responsive to recent hurricane disasters.
Emergencies are local and so too are the resource needs responsive to them. While considering the relevance of this program to the Memory Care Summit, the analogy emerges. Our industry is replete with diverse and disparate resource outlets represented by a myriad of constituents. Leadership influences are required to “connect the dots” and marshal alignment responsive to our own State of Emergency – the Future of Aging. If we want to support and augment critical public services, we should strive to become more familiar with their delivery frameworks and actively seek opportunities to leverage common language and structure.
A Quixotic Quest
A Hallmark of the Memory Care Summit is the final book-end of a human interest story – typically a first-person account from someone living with a Memory disorder. These stories are often heart wrenching and reinforce why we are in the business we are in. More importantly, the heart strings pulled remind us that this is not really a business alone – but more of a societal journey where we are all on a heroes’ quest of sorts together.
Brian LeBlanc is an International Dementia Advocate. In his own words, his personal mission is to act as a voice for those who are no longer able to speak. Brian allowed us to look inside his own experience with early-onset of dementia. He juxtaposed the active eloquence of his delivery and poise in speaking to us with a recent and personal video recording that captured an airport episode of what he characterizes as a fog – when the symptoms of his dis-ease are being expressed. The contrast between the energy of the gentleman presenting to us and the man we could observe being lost on screen was stark beyond words. In his closing, Brian read the Impossible Dream to us and asked that we listen through a particular lens – What if a Cure for Alzheimer’s was the Impossible Dream?
The Impossible Dream lyrics: Lyrics by Joe Darion In this song, Quixote explains his quest and the reasons behind it … in doing so, he captures the essence of the play and its philosophical underpinnings. (For me, it
Catalyst for Convergence
In reflecting upon the theme of the Memory Care Summit, we consider the broad implications this has on our industry at large. The Summit, with its diversity of program content and participants, proves a stellar example of research, education and practitioners coming together and making connections. This seemingly proves the formulary for moving forward – where we recognize and embrace the individuality of all stakeholders in this journey and the value proposition represented by all knowledge and experiences – taken together and appropriately combined. While connecting the dots seems daunting, coming together and collaborating on the opportunities and obstacles ahead is undoubtedly the prudent path of achievement. This is the essence of integrative thinking that is championed by the Erickson School and its programming. The Memory Care Summit is perhaps the microcosm illustration of this universal solution. As before, the Summit fuels our own thinking and continues to inform our own direction.
Systems and processes that we design with creative intention are the true enablers of engagement and progress – but they don’t create impact overnight. The Disney Organization and its Institute have been fine-tuning and memorializing their own leadership best practices and operational expertise for decades. Any attempt to model the end-result of all their learning would be quixotic absent a commitment to do the work!
What would the world look like if we could live, work, play, stay and age well in States of America that were truly United? The first step is to embrace a “Yes, And” mentality. The gears of policy, management and aging will not turn on their own – and certainly not in isolation. The Memory Care Summit induces our thinking about the value not just of creating relationships but also on cultivating them with purpose and humility. Connections – like the teeth in a cogwheel – make forward motion possible one increment at a time. Programs like The Memory Care Summit help to pave the way!
[1] Chopra, D. (2019). Can There Be a Science of Consciousness?. [online] Deepakchopra.com. Available at: https://www.deepakchopra.com/blog/article/5791 [Accessed 4 Feb. 2019].
CBS reporter Harry Butcher coined the phrase “fireside chat” to capture the informal and conversational tone of President Roosevelt’s speeches during the Great Depression. History reminds us that the President wanted to speak plainly to as many Americans as possible. At that time in the 1930’s, nearly 90% of the country owned a radio and this medium offered an unprecedented forum for reaching the masses. During the opening remarks of Aging2.0 Boston’s Fireside Chat, Massachusetts Secretary of Elder Affairs Alice Bonner honored the tradition of speaking simply by soliciting a commitment from the audience. She recognized that while we were all gathered at District Hall to celebrate the promise and opportunity for a shifting vision of old age, retirement and enabling technology, there was a more pressing priority for us to seize together. IF we recognize that aging is about families and community more than it is about “old people” alone THEN, we are quickly reminded that kindness and relationship-building represent the greatest investment of “human” capital into our shared future. More literally, we were asked to make eye contact and say hello to the people we encounter in our daily lives – especially seniors seemingly alone.
With that segue in mind, the event’s Moderator, Boston Globe reporter Robert Weisman, guided an inquiry into the many insights offered by Dr Joseph Coughlin and his AgeLab team in his newly published book, “The Longevity Economy.” At the surface level, it is a book that encourages business leaders to think differently about how to position for a demographic certainty that almost “defies description.” At a deeper, more functional level, Dr. Coughlin and his team have leveraged their own brand identity and intellect to help change the conversation about aging and old age. As contextual history emerged through the fireside conversation it became clear that AgeLab has a broad and active charge – to help create an “infrastructure of wellness.” MIT is uniquely positioned to support delivery of a wellness framework to communities given that they stand at the crossroads of so many industry constituents. None among them can offer wellness alone – this outcome will only be achieved through active collaboration and convergence fostered by all champions of change.
Driverless thinking
At one point in the evening’s Q&A session, an individual asked about the promise of the Autonomous Vehicle (AV) industry. The AgeLab doesn’t just have a front row seat for observing this trend – they are actively working with Toyota (among others) to advance an understanding of how drivers respond to the increasing complexity of our modern “operating” environment. But wait – here is the rub – in response, Dr. Coughlin emphasized that in spite of all the deep learning and research underway, no one is focused (to his knowledge) on “the 20 foot” challenge. In other words, while billions of dollars have been invested in this trending technology, the functional issue of getting a person with limited mobility into or out of a vehicle has not yet been fully addressed! This single insight serves as a metaphor to the shortcomings of mainstream marketing and product development strategies. When you go the extra mile and think about the problems that you are aiming to solve from multiple perspectives, you will naturally uncover a deficit that leads to greater opportunity. To echo Secretary Bonner’s insight – let’s be sure we are investing resources into the “right” opportunities.
Hubs
The “PieterExplainsTech” YouTube channel offers a variety of tech inspired explainer videos. In Hub, Switch or Router, the viewer is introduced to three network devices (as titled) and the way in which they connect to each other. When we think of the phrase “Hub” from a layman’s perspective, it conjures the spirit of scale and connection. Imagine the wooden wheel from tinker toy sets that empowered us to make a thousand iterations of ultimately the same thing. It is not surprising that coworking studios, or other Victor Hwangenthusiasts, would gravitate to this “hub” language when seeding their own role in a burgeoning innovation ecosystem. True to form, real insights require deep thinking – a natural extension of the consumer-centric, systemic design thinking that the AgeLab represents. From a literal perspective, Hubs in a network do not distinguish or direct signals intelligently – they only replicate and push data through the network while increasing the bandwidth of our systems in the process. Switches and Routers on the other hand, make it possible to direct information more purposefully.
Switching and Routing
We are living in a time where every industry sector touts (often with their own unique sound bites) the merits of integrative or interdisciplinary thinking and yet even a cursory inventory of these vertical spaces reveal gross intellectual redundancies. We borrow thought leaders and pass them through our conference circuits but we do not always stop to consider the efficacy of our economy, business models or community landscape. The “city” historically has been a mechanism for creating and distributing goods and services and it accomplishes this monumental feat by consuming our human scale. Absent progressively planned community infrastructure (let alone serious inner-engineering), we cannot even begin to think about achieving and distributing the dimensions of wellness at scale.
We could not dismiss the subtle irony of sitting in District Hall – an incredible public innovation space that is literally dwarfed by the Boston Seaport cityscape – while sharing sentiments about an altered future state. Our western culture is so highly fragmented because our economic landscape requires it to be so. The appealing catchphrase “infrastructure of wellness” implies that there is (or should be) a dynamic delivery system supporting the attainment of well-being. Dr Coughlin and others focused on “longevity” always ask (appropriately) if we want to just live long or live well. It seems as though we will always fall short of this latter goal if we continue to commoditize and externalize our health and the attainment of wellness while still developing communities for cars and commerce rather than for people and relationships.
A Silver-Lining for “Senior” Living
There are literally hundreds of thousands of industry constituents focusing on the same problems. If we learn to share our language and outcomes, we will begin to close the gaps in our learning very quickly. Organizations like the MIT AgeLab offer the promise of integrative thinking fueled by collaboration – enhanced by the authority and influence they represent. If we don’t know who we are meeting on the sidewalk – there is something wrong with the city or town we are living in. This is our 20 foot problem! Living alone together breeds lost opportunities for truly redefining and redirecting the future of aging where we can live long AND well!.
It is not likely that conventional cities or towns can be repurposed overnight. Nonetheless, The Senior Living Industry is uniquely positioned to influence this change landscape – dismantling the senior silos of traditional real estate development and introducing planned communities that are more purposefully connected to the broader community. Thought leaders like Dr. Joseph Coughlin and his team remind us that the future has not yet been built. The infrastructure of wellness represents a future scenario that might organize itself with greater clarity of purpose with a shared vision.
Like most of you, we have attended a lot of conferences, workshops and seminars since entering the “Senior Living” sector. As repeat attendees of The Annual Memory Care Summit and representing a graduate of The Erickson School, we have one single expectation from the UMBC Aging brand and team – delivery of academic and person-centered content that can “excite and delight” business as usual. We use that phrase intentionally because our own team has just finished a group read (on Audible – our go to “employee training” app) of Joseph Coughlin’s “Longevity Economy.” Coughlin, introduces – among several other things – the concept of “transcendent” design where we focus on developing consumer products that will excite and delight all ages and not seniors alone. He encourages all of us to embrace what we would consider a “strengths-based” approach – where we design products for ability and inclusive opportunity rather than trying to solve problems that only highlight deficits in the targeted end-user. This kind of thinking should apply equally to our planned communities and programming.
“Our heritage and ideals, our code and standards – the things we live by and teach our children – are preserved or diminished by how freely we exchange ideas and feelings”
–
Walt Disney
American entrepreneur,The Walt Disney Company
We are entering (or perhaps returning to) a new chapter in our Industry and culture where the curse of knowledge (in business and clinically) is being replaced by an emphasis on the fundamentals of imagination and relationship-building. What kind of future would we imagine, and then build, if we focused more exclusively on engaging across generations and sharing stories, experience and knowledge to that universal end?
Imagination vs Experience
If last year was about creating magical moments, and fine tuning company culture for sustained results, this year offered the charge to advance our Iconoclast Quotient (IQ) in recognition that while “Logic will take you from A to B, Imagination will take you anywhere.” Ideas and Interests are converging at an accelerated pace. If we want to offer health and wellness services to family, staff and residents, we will be required to meet our customers (all of them) wherever they are – and it will take the whole village to support their wants and needs effectively. In the past we have relied upon experience to light our path. In the immediate future we all need to be trailblazers of some degree.
Heroism and Incrementalism
In typical Erickson School fashion (this is the academic influence) a series of “pre-reading” materials were circulated via Dropbox to attendees – among these was a link from Bob Kramer of NIC to a recent New Yorker piece entitled “ The Heroism of Incremental Care” In the article, Atul Gawande shares an interesting metaphor surrounding the collapse of the Silver Bridge in 1967:
“The collapse signaled the need for a new strategy. Although much of the United States’ highway system was still relatively new, hundreds of bridges were more than forty years old and had been designed, like the Silver Bridge, for Model T traffic. Our system was entering middle age, and we didn’t have a plan for it.”
In this essay, emphasis was tied largely to the dichotomy of surgeons (heroes) and primary care physicians (incrementalists). For our purposes here, the relationship between outdated transportation infrastructure and our own bricks and mortar in Senior Living is key. We all know that we are developing products that are designed around realities/constraints and beliefs that are no longer relevant – like the Model T – and yet we still charge on without reconsidering the viability of our footings. It is worth emphasizing that EVERY time a guest speaker has joined the stage (we have been to four of the six events) they are emphatic about not wanting our “products or services.” We clearly need visionaries and iconoclasts to chart new courses for our Industry where we focus on engagement instead of behavior management alone.
5 Leadership Lessons from The Disney Institute
As leaders in the “Imagination” department, Mark Matheis offered the Disney Company’s’ perspective on how best to execute your plans once imagined:
Leaders establish, operationalize, and sustain the values and vision by which their organizations thrive.
Great leaders proactively establish values.
The more a vision can be expressed in a vivid, imaginative way, the more it will motivate people to action in the present.
Storytelling is an essential strategy for the communication of new ideas; people are more engaged and inspired by information presented through compelling narratives
The best legacy is not one that is fondly remembered, but one that is actively emulated
Value is created when Silos Break down
In “What the Smart Money Wants from You,” Robert Kramer, Founder & Strategic Advisor to The National Investment Center for Seniors Housing & Care, shared Industry Data and offered his own insight toward three drivers that are influencing our vision and narrative for the future:
The Longevity Revolution (Silver Tsunami)
Data, Robotics and Mass Customization
Healthcare Payment & Delivery Reform
“We always overestimate the change that will occur in the next two years…and underestimate the change that will occur in the next ten”
–
Bill Gates
American business magnate,Microsoft Corporation
In his engaging presentation, Bob Kramer offered his invaluable insight (replete with data metrics of course!) into the future of aging, how it is being redefined by emerging trends and the anticipated impact of “new retirees”. The later will be represented by “transitions” to encore professions as opposed to traditional retirement. Bob’s own circumstances are illustrative of this occurrence. Having been recognized as the CEO leader breeding the remarkable success of NIC as the premier research, educational and data source for the Seniors Housing & Care Industry, Bob now transitions to Chief Strategist for NIC. Undoubtedly he, like numerous other industry veterans, including the likes of John Erickson and Dr, Judah Ronch representing the Summit, will continue to influence and shape the future of aging. These are not declinists but rather industry treasures to engage and leverage.
The Declinist view of Retirement where seniors unplugged to enjoy their golden years is clearly outdated (like the Silver Bridge) and being replaced by a new emphasis on engagement where residents will want to be become integrated with the communities they choose in an intentional and productive way. As the “diaspora” of healthcare continues and senior services become “uberized,” it will become increasingly difficult to compete with the demand for full service and retail “life management” solutions. Lifestyle coupled with the presence of supportive care proving more intergenerational and “connected” will give rise to the trends of desire trumping needs. Where will we plug in to the new value equation as developers, operators, caregivers? Imagine a future of aging where business constituents are more “collaborative” than “competitive”. These trends are the leading indicators of integrative thinking (points from Dr. Ronch) and more integrated business models that emulate the real world.
Imagine a Cure for Alzheimer’s, Then What?
Scott Townsley’s session was centered around the assumption of a cure for Alzheimer’s. Whether or not a cure is on a horizon, this kind of open-ended / creative thinking enables us to focus on the survivable (or missing) attributes of our business and its offerings. Ironically, these attributes or amenities might actually define our core because they are likely “transcendent.”
“People don’t want to buy a quarter-inch drill, they want a quarter-inch hole”
–
Theodore Levitt
American economist and professor ,Harvard Business School
The traps of quality and superiority were addressed where the former represents the sentiment that well established organizations don’t need to change (until it is too late) and the latter assumes that a premium offering will also maintain its hegemony – except that customers ultimately crave simpler, cheaper incumbents. The final ¼” drill trap presented echoed the detriments of Marketing Myopia where we forget that we are selling solutions not widgets. If we are struggling to identify our own value proposition as an organization, this exercise creates an opportunity to highlight (and work to close) the gap between what we think we are selling (i.e. memory care) and what the market wants to purchase for themselves or loved ones (valued relationships and engagement).
Awe – using art to create relationships
If you are not aware, The Erickson School strategically front-ends the program with business and academic content and reserves the final book-end for local guest speakers that can help to ground and synthesize our thinking (by tempering it) with the raw emotional reality of people and their own first-person caregiving stories. Just before these guests arrived, we were primed for the transition through Anne Basting and a re-telling of her incredible work. She relayed how her experience of introducing the transformational power of theatre to people with memory care issues enabled them to engage instead of being alone together.
“The arts are a way of being in relationship, of seeing and shaping the world. My work brings the tools of imagination and creative expression to care relationships and systems in order to foster healing through community building. We cannot heal without story”
–
Anne Bastings
Artist, Scholar, Teacher,UWM Center on Age & Community; Founder, TimeSlips
It should not be surprising that an entertainment giant like Disney would proffer the same insights garnered from improvisational arts. Storytelling creates a safe space for everyone through abstraction – when you create an open environment, expression naturally fills the vacuum. What does this look like in the built environment? Or is architecture just a shell if it is filled with genuinely human activities? In any case, the challenge is not just how do we create a better physical space for Memory Care but rather, how can we establish a broader network of engaging human activities? We need life centers where everyone can thrive.
Short Circuits
To echo Atul Gawande’s essay once more, “Our ability to use information to understand and reshape the future is accelerating in multiple ways.” He continues to describe that “we have at least four major data inputs that reflect our health and wellness over time, (1) information about the state of your internal systems (from your imaging and lab-test results, your genome sequencing); (2) the state of your living conditions (your housing, community, economic, and environmental circumstances); (3) the state of the care you receive (what your practitioners have done and how well they did it, what medications and other treatments they have provided); and (4) the state of your behaviors (your patterns of sleep, exercise, stress, eating, sexual activity, adherence to treatments).”
When you consider the scope of these inputs, it becomes clear that we will need more bandwidth to capture all of this data and make use of it in a meaningful way. It is unlikely that a sole “hero” provider will venture off into the forest and return with a miracle solution for Alzheimer’s or any other dis-ease. Of course, if you have eyes to see and ears to hear, we might already be the miracle we are searching for.
“Remember, creative power will not operate itself. Knowing what to do is not enough. You, imagination’s operant power, must be willing to assume that things are as you desire them to be before they can ever come to pass.”
–
Neville Goddard
Author and Teacher
In this sixth year of the summit, we were all called to cultivate our iconoclastic quotient (IQ) so that the future we imagine is built on solid ground instead of crumbling foundations. We were also reminded that if engagement is the ultimate prescription, then we cannot succeed in isolation. Let’s take inventory of our respective strengths so that we can catalog and distribute the dimensional inputs of health and wellness together as due-diligence only. The shared moon-shot is to leverage the data and best practices to craft a new story about how we can age more actively and remain engaged together.
